Vaccination, antiviral therapy help curb HCC incidence, mortality in Taiwan

Universal hepatitis B vaccination and antiviral therapy against viral hepatitis have helped minimize hepatocellular carcinoma (HCC) incidence and mortality rates among Taiwan’s young and middle-aged populations, a recent study has found.

Moreover, providing universal healthcare has yielded a population-wide benefit, improving case-fatality rates across all age groups.

Drawing from a population-based registry, the researchers retrieved HCC mortality and incidence data collected between 1979 and 2016. Comparisons were made between the time period before (period 1) and after the implementation of universal hepatitis B vaccination in 1984 (period 2), universal healthcare in 1995 (period 3), and viral hepatitis therapy in 2003 (period 4).

In young participants, aged 30 and below, HCC mortality declined consistently across the entire study period. Incidence, on the other hand, rose from period 1 to 3 before dropping steeply during period 4.

Between periods 1 and 2, vaccination led to a nonsignificant drop in HCC incidence (relative rate [RR], 0.82, 95 percent confidence interval [CI], 0.63–1.07; p=0.15), while those who were unvaccinated saw a significant rise in incidence (RR, 1.49, 95 percent CI, 1.31–1.70; p<0.0001). In relative terms, vaccination reduced hepatitis B incidence by 35.9 percent in this population.

Moreover, universal antiviral therapy likewise yielded strong population-wide benefits, reducing the incidence of HCC by 14.9 percent and 15.4 percent in individuals aged 30–49 and 50–69 years, respectively.

“These findings provide new insights into the optimal resource allocation to different intervention programs for HCC targeting in different age groups,” the researchers said.